A case of Eosinophilic Ascites noted in Eosinophilic Gastroenteritis / 대한임상병리학회지

The observation of eosinophilic ascites is uncommon. They can be noted in parasitic disease, malignant condition, vasculitis, idiopathic hypereosinophilic syndrome or allergic disorders including eosinophilic gastroenteritis, which is a rare disease of unknown etiology characterized by massive tissue infiltration of eosinophils in the layers of any area of gastrointestinal[GI] tract. Clinical manifestations are related to the level of the histologic infiltration in the wall, and the segment of the GI tract involved. Mucosal involvement may result in abdominal pain, nausea, vomiting, diarrhea and weight loss. Muscle layer involvements have obstructive symptoms. Subserosal eosinophilic infiltration may result in the development of eosinophilic ascites. We experienced a case of eosinophilic ascites as manifestation of eosinophilic gastroenteritis in a 43-year old man who also had jejunal obstruction. High proportion of eosinophil count was noted in the ascites, however peripheral blood eosinophilia was not noted. Parasitologic studies were negative. Histologic examination of segment of jejunum showed heavy transmural infiltration of eosinophils which were extended to subserosal layer. Eosinophilic ascites noted in eosinophilic gastroenteritis, though not a common disease entity, had not been described in the laboratory medicine related papers in Korea. Therefore we report this case as an example of eosinophilic ascites.

Unusual Morphology of Eosinophil Nucleus: Presented with Double Chromatin Filament Bridge: Report of Three Cases / 대한임상병리학회지

We found an unusual morphology of eosinophil nucleus having longer chromatin filament in addition to a single narrow chromatin bridge. The nucleus having two chromatin filament bridge looked like two legged eosinophil, instead of usual glasses shape. As the physiologic function of the nucleus of granulocyte segmentation and the mechanism by which the lobes are formed during differention is still unknown, we could not know the definite nature and significance of these double chromatin filament. However we could suggest that they may be a reactive change of eosinophilia. This not uncommon morphology has not been described as yet. Here we report three cases of unusual morphology of eosinophil nucleus presenting double chromatin filament bridge, one case with a band form nucleus looked like ring shape, with brief review of literatures.

Metachromatic Globules in the Degenerated Brilliant Cresyl Blue Stain Proved to be Fibronectin / 대한임상병리학회지

BACKGROUND: We incidentally found purple metachromatic globules looked like red blood cells in the blood smears of a leukemic patient for reticulocyte count. The metachromatic globules were various in size and shape. The stain solution of brilliant cresyl blue was degenerated to pH change of 3.5. To find out the nature of these metachromatic globules, this study was performed. METHODS: Reticulocyte count stain was performed on the slide smears with EDTA bloods, their plasma, and sera of leukemic patients and normal persons using the degenerated brilliant cresyl blue stain solution. To clarify the nature of the metachromatic globules, we also carried out immunocytochemical stain with monoclonal antibodies to fibronectin and fibrinogen on the same slide smears prepared. The pH of the stain solution checked. RESULTS: EDTA blood, plasma and human fibrinogen product showed the same metachromatic globules. But in serum smear the metachromasia was faint and globule shape was not noted. Purified human fibrinogen showed reticulated pattern metachromasia. Immunocytochemical stain with monoclonal antibody to the fibronectin showed small dot, round, budding, and globule form positivity in the smear of EDTA blood, plasma, and human fibrinogen product. Platelets also showed positive reaction. Purified human fibrinogen showed no positive reaction. Immunocytochemical stain with monoclonal antibody to the fibrinogen on the other hands showed reticulated pattern positivity in EDTA blood, plasma, human fibrinogen product and purified human fibrinogen. Smear with serum showed no positive reaction. The stain solution was degenerated to acidic pH of 3.5. CONCLUSIONS: Fibronectin, ubiquitous adhesive protein, was easily observed by simple stain method. Further study should be followed, however we suggest detection of plasma fibronectin which is costly, could be easily done by simple stain method.

Unusual Morphology of Aberrant Forms of Bacteria in Urine: Presented with Grotesque-Giant Form with Central Emptiness and Fusiform Ends / 대한임상병리학회지

Unusual morphology of aberrant forms of bacteria, presented with grotesque-giant form, 15 m 3 m, with central emptiness and fusiform ends was observed in urine Gram stain from a 26-year-old woman who was admitted with the symptoms of acute urinary tract infection. On wet smear, these bacilli were markedly swollen, yeast-like organisms. In addition to normal shaped bacilli, various shapes of another aberrant bacteria, such as long bacilli, filamentous form, filamentous form with central bulge, and bipolar staining with central emptiness were also observed in the same specimen. The morphologic characteristics of these unusual aberrant bacilli were more distinct on Papanicolaou stain than on Gram stain. In Korea, where antimicrobial agents are overused and disused, the frequency of observing the aberrant bacteria would be much higher than cases reported. Here we report unusual morphology of aberrant forms of Escherichia coli with the emphasis on awaring of the potential appearance of such bacilli in clinical specimen and avoiding confusion with fungi and other naturally filamentous organisms.